The effectiveness of electroconvulsive therapy: A literature review

2010 ◽  
Vol 19 (4) ◽  
pp. 333-347 ◽  
Author(s):  
John Read ◽  
Richard Bentall
Keyword(s):  
Electroconvulsive Therapy ◽  
Conflicts Of Interest ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Anterograde Amnesia ◽  
Brain Dysfunction ◽  
Risk Of Death ◽  
Increased Risk ◽  
Meta Analyses ◽  
The Cost

SUMMARYAim – To review the literature on the efficacy of electroconvulsive therapy [ECT], with a particular focus on depression, its primary target group. Methods – PsycINFO, Medline, previous reviews and meta-analyses were searched in an attempt to identify all studies comparing ECT with simulated-ECT [SECT]. Results – These placebo controlled studies show minimal support for effectiveness with either depression or ‘schizophrenia’ during the course of treatment (i.e. only for some patients, on some measures, sometimes perceived only by psychiatrists but not by other raters), and no evidence, for either diagnostic group, of any benefits beyond the treatment period. There are no placebo-controlled studies evaluating the hypothesis that ECT prevents suicide, and no robust evidence from other kinds of studies to support the hypothesis. Conclusions – Given the strong evidence (summarised here) of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retrograde and anterograde amnesia, and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.Declaration of Interest: Neither author has any financial conflicts of interest in relation to this paper.

scholarly journals Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009

2017 ◽  
Vol 19 (1) ◽  
pp. 5-23 ◽  
Author(s):  
John Read ◽  
Chelsea Arnold
Keyword(s):  
Electroconvulsive Therapy ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
End Of Treatment ◽  
Persistent Memory ◽  
Contradictory Evidence ◽  
Meta Analyses ◽  
The Cost ◽  
Robust Evidence

Background:A 2010 review of studies, previous reviews and meta-analyses found minimal evidence that electroconvulsive therapy (ECT) for depression was more effective than placebo during the treatment period and no evidence at all of efficacy beyond the end of treatment. The current review explored whether any contradictory evidence has since been generated.Method:MEDLINE and PsycINFO were searched to identify all post-2009 studies that had compared ECT and simulated ECT for depression, or had in any other way generated valid depression data for ECT recipients at two or more points in time.Results:Ninety-one studies met inclusion criteria. There were no new placebo-controlled trials. There have now been no such studies since 1985. Only 4 placebo-controlled studies have ever produced data beyond the end of treatment, none of which have found any advantage for ECT over placebo. Of the 91 studies, only 2 aimed to evaluate the efficacy of ECT. Both were severely flawed. None of the other 89 produced robust evidence that ECT is effective for depression, primarily because at least 60% maintained ECT participants on medication and 89% produced no meaningful follow-up data beyond the end of treatment. No studies investigated whether ECT prevents suicide.Conclusions:There is still no evidence that ECT is more effective than placebo for depression reduction or suicide prevention. Given the well-documented high risk of persistent memory dysfunction, the cost-benefit analysis for ECT remains so poor that its use cannot be scientifically, or ethically, justified.

In Code(rs) We Trust

2019 ◽  
pp. 58-82 ◽  
Author(s):  
Angela Walch
Keyword(s):  
Data Structures ◽  
Conflicts Of Interest ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Software Developers ◽  
Decentralized Governance ◽  
The Cost ◽  
Key Questions

This chapter addresses the myth of ‘decentralized governance’ of public blockchains, arguing that certain people who create, operate, or reshape them function much like fiduciaries of those who rely on these data structures. It compares the role of leading software developers and Frankel’s conception of a ‘fiduciary’ and finds much in common, as users place extreme trust in the developers to be both competent and loyal (i.e. to be free of conflicts of interest). The chapter frames the cost–benefit analysis necessary to evaluate whether it is wise to treat these parties as fiduciaries, and outlines key questions needed to flesh out the fiduciary categorization. For example, which software developers are influential enough to resemble fiduciaries? Are all users of a blockchain ‘entrustors’ of the fiduciaries who operate the blockchain, or only a subset of those who rely on the blockchain? The chapter concludes by considering the broader implications of treating software developers as fiduciaries, given the existing accountability paradigm that largely shields them from liability for the code they create.

Hostile Takeovers and Anti-takeover Defenses in the Russian Corporate Market

2007 ◽  
pp. 70-84 ◽  
Author(s):  
E. Demidova
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Hostile Takeovers ◽  
Russian Market ◽  
Takeover Defenses ◽  
The Cost ◽  
European Markets

This article analyzes definitions and the role of hostile takeovers at the Russian and European markets for corporate control. It develops the methodology of assessing the efficiency of anti-takeover defenses adapted to the conditions of the Russian market. The paper uses the cost-benefit analysis, where the costs and benefits of the pre-bid and post-bid defenses are compared.

What's it Worth? Improving Surface Water Quality

1999 ◽  
Vol 40 (10) ◽  
pp. 153-159 ◽  
Author(s):  
D. H. Newsome ◽  
C. D. Stephen
Keyword(s):  
Water Quality ◽  
Surface Water ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Surface Water Quality ◽  
Control Measures ◽  
Benefit Analysis ◽  
The Cost

Many countries are investing in measures to improve surface water quality, but the investment programmes for so doing are increasingly becoming subject to cost-benefit analysis. Whilst the cost of control measures can usually be determined for individual improvement schemes, there are currently no established procedures for valuing the benefits attributable to improved surface water quality. The paper describes a methodology that has been derived that now makes this possible.

scholarly journals Economic Analysis of the Use of VCS2000 for Pork Carcass Meat Yield Grading in Korea

Animals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1297
Author(s):  
Juntae Kim ◽  
Hyo-Dong Han ◽  
Wang Yeol Lee ◽  
Collins Wakholi ◽  
Jayoung Lee ◽  
...  
Keyword(s):  
Economic Analysis ◽  
Net Present Value ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Feed Consumption ◽  
Cost Ratio ◽  
Benefit Analysis ◽  
Labor Costs ◽  
Meat Yield ◽  
The Cost

Currently, the pork industry is incorporating in-line automation with the aim of increasing the slaughtered pork carcass throughput while monitoring quality and safety. In Korea, 21 parameters (such as back-fat thickness and carcass weight) are used for quality grading of pork carcasses. Recently, the VCS2000 system—an automatic meat yield grading machine system—was introduced to enhance grading efficiency and therefore increase pork carcass production. The VCS2000 system is able to predict pork carcass yield based on image analysis. This study also conducted an economic analysis of the system using a cost—benefit analysis. The subsection items of the cost-benefit analysis considered were net present value (NPV), internal rate of return (IRR), and benefit/cost ratio (BC ratio), and each method was verified through sensitivity analysis. For our analysis, the benefits were grouped into three categories: the benefits of reducing labor costs, the benefits of improving meat yield production, and the benefits of reducing pig feed consumption through optimization. The cost-benefit analysis of the system resulted in an NPV of approximately 615.6 million Korean won, an IRR of 13.52%, and a B/C ratio of 1.65.

scholarly journals Beyond the Stern Review: Lessons from a risky venture at the limits of the cost–benefit analysis

2009 ◽  
Vol 68 (10) ◽  
pp. 2479-2484 ◽  
Author(s):  
Jean-Charles Hourcade ◽  
Philippe Ambrosi ◽  
Patrice Dumas
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Stern Review ◽  
The Cost

Inferring age from otolith measurements: a review and a new approach

2004 ◽  
Vol 61 (7) ◽  
pp. 1269-1284 ◽  
Author(s):  
RIC Chris Francis ◽  
Steven E Campana
Keyword(s):  
Simulation Experiment ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
New Method ◽  
Population Parameters ◽  
Benefit Analysis ◽  
Mixture Analysis ◽  
New Approach ◽  
Individual Fish ◽  
The Cost

In 1985, Boehlert (Fish. Bull. 83: 103–117) suggested that fish age could be estimated from otolith measurements. Since that time, a number of inferential techniques have been proposed and tested in a range of species. A review of these techniques shows that all are subject to at least one of four types of bias. In addition, they all focus on assigning ages to individual fish, whereas the estimation of population parameters (particularly proportions at age) is usually the goal. We propose a new flexible method of inference based on mixture analysis, which avoids these biases and makes better use of the data. We argue that the most appropriate technique for evaluating the performance of these methods is a cost–benefit analysis that compares the cost of the estimated ages with that of the traditional annulus count method. A simulation experiment is used to illustrate both the new method and the cost–benefit analysis.

Drug costs and treatment choices: a DTB symposium

1993 ◽  
Vol 31 (11) ◽  
pp. 41-44
Keyword(s):  
Cost Benefit Analysis ◽  
Health Benefit ◽  
Cost Benefit ◽  
Drug Costs ◽  
Benefit Analysis ◽  
Treatment Choices ◽  
The Subject ◽  
The Cost ◽  
The Relationship ◽  
Service Managers

The relationship between drug costs and treatment choices was the subject of the first annual Drug and Therapeutics Bulletin symposium held in March 1993.* In a time of severe financial constraints for the NHS it is important that the money available is well spent. In the case of treatment that means the benefits must be worth the cost. There is, however, no agreed way of deciding when a particular health benefit to an individual is worth the cost to the NHS. Drug prices are easier to measure and more consistent than the prices of other treatments, and may be more amenable to cost-benefit analysis. Treatment choices are made primarily by doctors but with critical input from patients, pharmacists, nurses and health service managers. In this article we give an overview of the symposium at which speakers described ways in which drug costs and treatment choices were tackled in general practice (Ann McPherson, John Howie), in hospital (Dorothy Anderson), in clinical research and audit (Iain Chalmers, Alison Frater), by consumers (Anna Bradley), by health economists (Mike Drummond) and by government (Joe Collier). We also take into account points raised in discussion by the participants.

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